Gynaecomastia Flashcards

1
Q

What drugs can cause gynecomastia?

A
  • Spironolactone (most common drug cause)
  • Cimetidine
  • Digoxin
  • Cannabis
  • Finasteride
  • Gonadorelin analogues e.g. Goserelin, buserelin
  • Oestrogens
  • Anabolic steroids
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2
Q

What are some physiological causes of gynecomastia?

A
  • Physiological: normal in puberty
  • Syndromes with androgen deficiency: Kallman’s, Klinefelter’s
  • Testicular failure: e.g. mumps
  • Liver disease
  • Testicular cancer e.g. Non-seminomatous secreting hCG
  • Ectopic tumour secretion
  • Hyperthyroidism
  • Haemodialysis
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3
Q

What are some very rare causes of gynecomastia?

A
  • Tricyclics
  • Isoniazid
  • CCBs
  • Heroin
  • Busulfan
  • Methyldopa
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4
Q

What investigations should be done in new onset gynecomastia?

A
  • Hormone profile
  • Thyroid function
  • Liver function
  • Renal function
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5
Q

If there is unilateral gynecomastia or unilateral change in existing gynecomastia, what should be done?

A

Refer to exclude breast cancer

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6
Q

If a patient is thought to have Klinefelter’s syndrome, what is the next step in management?

A

Refer to a geneticist & if considering having children they may need referral to the fertility clinic once diagnosis is confirmed.

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